Kelly K Frederick

NPI #1821652876 in Warren, Indiana

Provider Information

NPI Number: 1821652876
Entity Type: Individual
Name: Kelly K Frederick
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - School
Enumeration Date: Apr 25, 2019
Last Updated: Aug 19, 2021

Practice Location

Address: 1063 E 900 S
City: Warren
State: Indiana
ZIP Code: 46792-9214
Phone: (260) 468-3093

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - School — School	103TS0200X	Primary
Behavior Technician	106S00000X

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